New research from Italy suggests that mesothelioma treatment strategies need to be a lot more flexible than they have been up until now. That’s because mesothelioma cells are themselves a lot more flexible than previously understood.

This new research makes clear just how flexible they are. Actually a better word than “flexible” might be “adaptable.” The research shows that mesothelioma cells can adapt and become harder to kill.

As a result, mesothelioma treatment specialists should plan their care strategies differently. So say the scientists behind this new research.

They suggest your doctor plan for the possibility that the type of mesothelioma cell making up your tumor today won’t be the same type a year from now.

Mesothelioma Helped by EMT-MErT Hybrid Process

The researchers report in Oncotarget that mesothelioma cells get this ability to change type from a biological process that’s a hybrid between two other processes.

The two other processes are familiar ones. They help you heal if you get a cut. But the hybrid version is not your helper. It works against you.

One of the familiar and helpful processes goes by the name EMT. That stands for epithelial-mesenchymal transition.

The other process is known as MErT, or mesenchymal-epithelial reverse transition. The EMT-MErT hybrid is a process that was pretty much unidentified until this new research came along.

The hybrid process seems to allow mesothelioma cells to dodge death by changing them from one cell type to another.

For example, say you have the epithelioid type of mesothelioma. That’s the cell type that responds best to treatment. Responsiveness is important. Responsiveness usually means you can look forward to a longer mesothelioma survival time.

If you have the epithelioid type of mesothelioma, you’ll typically survive longer than if you have the biphasic or sarcomatoid type of mesothelioma cell. Those two are less responsive to treatment. The sarcomatoid type is the least responsive of all.

Mesothelioma Treatment Methods Must Change If Cell Type Do

So your doctor designs a treatment strategy using the procedures and medicines that work best against the epithelioid type of mesothelioma. You’re doing great at first. But then the mesothelioma seems to be getting the upper hand.

The explanation may be that the mesothelioma cells inside you have changed to either the biphasic or sarcomatoid type.

The treatments you’ve been receiving aren’t geared to dealing with either of those two cell types. There’s less responsiveness. That will likely cut into your mesothelioma survival time.

The researchers say the answer to this is for your doctor to be aware of the possibility of cell-type change.

They also recommend doctors consider including epigenetic regulator inhibitors in their treatment plans. Epigenetic regulator inhibitors are molecules that may be able to prevent the hybrid process from working.

The researchers are from Italy’s Department of Diagnostic Pathology and Laboratory Medicine, Department of Experimental Oncology and Molecular Medicine, Department of Cancer Medicine and the Fondazione IRCCS Istituto Nazionale dei Tumori, all in the city of Milan. Also participating were researchers from the University of Trieste and CRO Aviano National Cancer Institute.

The research team tried to understand this hybrid process by studying medical records and tumor samples from 21 patients with malignant peritoneal mesothelioma.

The title of the article is: “Epithelioid Peritoneal Mesothelioma: A Hybrid Phenotype within a Mesenchymal-Epithelial/Epithelial-Mesenchymal Transition Framework.”

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